| Titre : | Influenza preparedness and response. Persistence and Change in Disparities in HIV Infection Among Injection Drug Users in New York City After Large-Scale Syringe Exchange Programs. (2009) |
| Auteurs : | Don-C DES JARLAIS ; Kamyar ARASTEH ; Samuel-R FRIEDMAN ; Holly HAGAN ; Courtney MCKNIGHT ; David-C PERLMAN |
| Type de document : | Article |
| Dans : | American journal of public health (vol. 99, 2009) |
| Pagination : | S445-S451 |
| Langues: | Anglais |
| Mots-clés : | Toxicomanie ; Changement ; Sida ; Voie intraveineuse ; Milieu urbain ; Seringue ; Echange seringue ; Programme ; Toxicomane ; Homme ; Virose ; Infection ; Amérique ; Immunopathologie ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0x8FG9q. Diffusion soumise à autorisation]. Objectives. We examined racial/ethnic disparities in HIV infection among injection drug users (IDUs) before and after implementation of large-scale syringe exchange programs in New York City. Methods. Participants were recruited from IDUs entering the Beth Israel drug detoxification program in New York City. Participants (n=1203) recruited from 1990 through 1994, prior to large-scale syringe exchange programs (pre-exchange), were compared with 1109 participants who began injecting in 1995 or later and were interviewed in 1995 through 2008 (post-exchange). Results. There were large differences in HIV prevalence among pre-exchange vs post-exchange participants (African Americans, 57% vs 15% ; Hispanics, 53% vs 5% ; Whites, 27% vs 3%). Pre-and post-exchange relative disparities of HIV prevalence were similar for African Americans vs Whites (adjusted odds ratio [AOR]=3.46,95% confidence interval [Cl]=2.41,4.96 and AOR=4.02,95% CI=1.67,9.69, respectively) and Hispanics vs Whites (AOR=1.76,95% CI=1.49,2.09 and AOR=1.49,95% CI=1.02,2.17). Racial/ethnic group differences in risk behavior did not explain differences in HIV prevalence. Conclusions. New interventions are needed to address continuing disparities in HIV infection among IDUs, but self-reported risk behaviors by themselves may not be adequate outcome measures for evaluating interventions to reduce racial/ethnic disparities in HIV infection. |
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